What I've Learned From 7 Years of Working with High School Athletes

What I've Learned From 7 Years of Working with High School Athletes

I started working with high school athletes in 2015 as a first year DPT (Doctor of Physical Therapy) student. An important lesson I learned early on is that most great clinicians are also great communicators. After all, it's not what you know that matters the most. It's what your patient or client understands about their rehab or training journey that improves buy in and leads to great results.

In PT school, we learned the science of how to improve human movement. We weren't taught valuable soft skills like communication, empathy, and conflict management. In an attempt to be a more well-rounded clinician (and person in general), I sought out real-life coaching opportunities. I felt like the most logical place to start was with high school athletes. Most high schoolers have no experience, so my ability to relate to them and teach them in a way that they would understand would be put to the test. Seven years later and here we are. This article will discuss the good, the bad, and my attempt at "filling the gaps" between what is commonly done in youth sports today and what I believe should be standard practice going forward.


I love working with high school athletes because I get to teach them what I wish I knew back in the day. I see my younger self in a lot of them - willing to work hard, eager to learn, but lacking the knowledge needed to do it themselves. Once youth athletes start to understand basic movement concepts and they develop the habit of consistent and focused training, results come fast. It's truly rewarding to help kids go through the following process:

  1. Establish goal(s). "I want to be more athletic."
  2. Learn new skills and encounter resistance. "This is harder than I thought it would be... I am sore... I have to do this 3x/week?!"
  3. Overcome resistance because the desire to improve is greater than the struggle of doing the things that need to be done. "I actually don't mind feeling sore or staying disciplined because I know that my hard work will pay off."
  4. Achieve goal. "Wow, I feel strong and I can jump higher! I wonder what else I can do..."   

I believe that good coaches are vital for youth development. They have the opportunity (and responsibility) to teach the skills and habits needed to excel not only in sport, but in all areas of life. If you have the discipline and work ethic to apply yourself on court or in the weight room, you have the tools needed to do the same in school, in business, and in your relationships. The skills that are required will be different based on the goal, but the process remains the same. Having now been on both sides of the fence, I can confidently (and without shame) say that I took many of my coaches for granted. The work I do now is my attempt at paying it forward to the next generation.



"Early specialization" is defined as year round intensive training in a single sport at the exclusion of other sports (Jayanthi et al, 2015). Risks of early specialization include higher injury rates, increased psychological stress, and burnout. From a physical standpoint, when you participate in different sports or activities, your body uses different movement patterns and is therefore exposed to different kinds of stress. This is especially important in developing athletes who are, as a whole, the least prepared for being able to tolerate high volumes of sport-specific training. 

Additionally, most youth athletes today have determined their sport of choice and have specialized in it far before finishing puberty. If we know that puberty brings about hormonal changes that assist in muscle and bone development (among other things), we should be cautious not to overload these athletes beyond a level that they can adequately recover from. As a physical therapist and performance coach who works with this demographic, I'm often doing damage control with kids who are hurt and need to slow down, but who want to keep playing at the frequency that caused problems to begin with. A typical conversation looks like this: 

  • Question 1: "Are you (the youth athlete) healthy and pain free?"
  • If the answer is "no"...
  • Question 2: "What is your current weekly training/playing schedule?"
  • If the schedule objectively involves too much specific, high intensity training/sport practice...
  • Question 3: "How can we adjust your schedule so that there is a balance between getting better at the sport you love while also building your body up so that you can stay healthy and play without pain?"
  • This is where we have a discussion about physical therapy, strength training, etc.

You would think that this thought process would be well received by all parties involved, and that the appropriate changes would be made for the betterment of the athlete. However, that is often not the case. For people who are stuck in a "more is better" mindset, I would encourage you to shift to a "quality over quantity" approach. With that in mind, the next logical question to ask is, "what does quality look like?"



"To document and share the best practices for building world class athletes."

As it relates to the discussion at hand, these "best practices" are what I hope youth athletes begin to implement so that they get hurt less and their training as a whole becomes more balanced. If you're a visual learner like me, the following image will help drive this point home. 

As a general starting point, "balanced training" involves an even distribution of skills training, game play, and performance training. 

  • Skills training helps you improve the technical components of the game - ex: ball handling, shooting, and passing. 
  • Game play provides an opportunity to learn the tactical side of the game - ex: decision making, spacing, etc. In other words, it allows you to apply your skills to in-game situations. 
  • Lastly, the goal of performance training is to improve your physical "tools" (mobility, coordination, strength, speed, and sport-specific endurance) so that your body can handle the demands of training and competition without breaking down. 

Think of the overall structure in the image above (let's call it a house) as a visual representation of how good of a basketball player you are. As each pillar grows, so will the house. A player who has done more skills training, played more games, and who has worked on his or her body more has a bigger house than a player who hasn't.



The bigger the house, the better the player. But here's the kicker... 

    Even if you have a balanced training plan in place, if you try to build the house too quickly, it will crumble!! It wouldn't make sense to have a training plan where every day includes a high intensity skills session, a full game, and a tough lift in the weight room. Although that plan is technically balanced (ie, you're developing all 3 pillars), it's way too much stress on your body. 

    After all, you're only as good as the stress you're able to recover from! Your body does not care if the stress comes from skills training, game play, or performance training. It cares about the volume (amount) and the intensity (degree of difficulty) of the applied stress. The way you build your house without making it crumble is by methodically applying stress to your body, allowing it to recover/adapt, and repeating. 

    An important term to help solidify your understanding of the training process is the adaptation threshold. If you've spent any time training, you inherently understand this concept.

    • Not enough stress = no positive change (you stay the same). 
    • Too much stress = negative change aka overtraining.
    • Just the right amount and intensity of stress = Progress

    The key to making consistent progress is to apply stress to your body that exceeds the adaptation threshold but is below the threshold for overtraining. Once your body adapts, baseline function aka homeostasis will increase. In order to continue to improve baseline function, more bouts of appropriately dosed stress must be applied. 

    A better approach to the scenario above might be to do a low intensity skills session (form shooting and light ball handling), then play a game, then do a moderate intensity lift focusing on restoring mobility and slow strength for tendon health. Again, all three pillars are hit, but volumes and intensities are adjusted to ensure the athlete can adapt.


    To be the best player possible, you must have the biggest house. To have the biggest house, you must have the biggest pillars. This means that your skill, game experience, and body are developed to the highest degree. In order to grow your pillars, you must apply stress to the body. Making progress and avoiding injury are predicated on your ability to know where your adaptation and overtraining thresholds are so that you know how to dose your training. 

    The tricky part is that as you improve, the lines that represent your baseline function, adaptation threshold, and overtraining threshold will rise. Training methods (stressors) that previously worked (made you adapt) will not work anymore because the stress now falls short of your adaptation threshold. This is why programs need to include progressive overload and why youth athletes should be trained differently than athletes with a higher training age. 

    If you can start to view your (insert sport or activity) training as a house that needs three well-developed pillars to stand on, you're off to a good start. If you can also picture the applied stress graph and start to categorize training methods as stressors that either do or do not exceed the adaptation threshold, you're off to a great start! If you can then figure out where your adaptation and overtraining thresholds are relative to your baseline function, you're an absolute beast!!! (For the record, I don't expect you to be able to figure out the last point unless you've had a good amount of experience either going through the process yourself or leading other athletes through it.) 

    After reading this article, my hope is simply that you can start to view the training process through a different lens. If you’ve held onto the “more is better” mindset and realize that your body is now paying the price, I encourage you to shift your thinking. A more balanced program with only high quality components will probably do a world of good for you. Figuring out what that looks like might take some trial and error, but if longevity is your goal, the work will be worth it. This is a topic that is near to my heart because I hate to see so many young athletes hurt. The first step in creating change is becoming aware of a problem. The second step is to do something about it. Be on the lookout for more blogs and future programs where I take out the guesswork and show you what a high quality, balanced program looks like for developing basketball players.

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